Diagnosis and Epidemiology of Esophageal and Gastric Cancers

1. Which of the following are predisposing factors to squamous cell carcinoma?

Excessive sunlight exposure

Obesity

Tobacco and alcohol useChronic stricturesAchalasiaDiverticulaUpper esophageal webs

Genetic predisposition

Squamous cell carcinoma is a type of esophageal cancer that is associated with certain risk factors including tobacco and alcohol use, chronic strictures, achalasia, diverticula, and upper esophageal webs. Other factors like obesity, excessive sunlight exposure, and genetic predisposition are not directly linked to squamous cell carcinoma.

Explanation

Squamous cell carcinoma is a type of esophageal cancer that is associated with certain risk factors including tobacco and alcohol use, chronic strictures, achalasia, diverticula, and upper esophageal webs. Other factors like obesity, excessive sunlight exposure, and genetic predisposition are not directly linked to squamous cell carcinoma.

2. What is the likely diagnosis of this image, taken from the middle 1/3 of the esophagus?

Squamous cell carcinoma

Esophageal varices

Gastroesophageal reflux disease (GERD)

Barrett's esophagus

The image from the middle 1/3 of the esophagus suggests Squamous cell carcinoma due to the abnormal cell growth that is typical of this type of cancer in that region.

Explanation

The image from the middle 1/3 of the esophagus suggests Squamous cell carcinoma due to the abnormal cell growth that is typical of this type of cancer in that region.

3. What is the prevalence of SCCA and adenocarcinoma in the US and worldwide?

In the US, adenocarcinoma is more common than SCCA.

SCCA is more prevalent in the US while adenocarcinoma is more prevalent worldwide.

SCCA represents 50% of esophageal cancers worldwide, while adenocarcinoma accounts for the remaining 50%.

The correct answer highlights the equal prevalence of SCCA and adenocarcinoma in the US, while specifying the predominant role of SCCA in esophageal cancers worldwide with a ratio of 90% to 10%.

Explanation

The correct answer highlights the equal prevalence of SCCA and adenocarcinoma in the US, while specifying the predominant role of SCCA in esophageal cancers worldwide with a ratio of 90% to 10%.

4. What is the diagnosis for the image taken from the esophagus of a patient with longstanding GERD, and what is the lifetime risk of adenocarcinoma in patients with this condition?

Gastric ulcer with metaplasia, 5% lifetime risk of adenocarcinoma

Eosinophilic esophagitis with strictures, 3% lifetime risk of adenocarcinoma

Hiatal hernia with reflux esophagitis, 15% lifetime risk of adenocarcinoma

Barrett's esophagus with dysplasia10% lifetime risk of adenocarcinoma

Barrett's esophagus is the correct diagnosis in this case, characterized by the replacement of the normal squamous epithelium with columnar epithelium in the esophagus. Dysplasia indicates abnormal cellular changes that may progress to cancer. The lifetime risk of adenocarcinoma in patients with Barrett's esophagus is approximately 10%, making it a significant concern.

Explanation

Barrett's esophagus is the correct diagnosis in this case, characterized by the replacement of the normal squamous epithelium with columnar epithelium in the esophagus. Dysplasia indicates abnormal cellular changes that may progress to cancer. The lifetime risk of adenocarcinoma in patients with Barrett's esophagus is approximately 10%, making it a significant concern.

5. What is the diagnosis and key histological findings for a patient who developed this condition after longstanding Barrett's esophagus?

Chronic esophagitis with eosinophilic infiltration and basal zone hyperplasia.

Barrett's esophagus, showing squamous epithelium with goblet cells.

Adenocarcinoma, seen here in endoscopic viewMalignant, intestinal type glands in the distal 1/3 of the esophagus are typical of adenocarcinoma

Esophageal stricture, characterized by narrowing of the esophagus due to scar tissue formation.

The correct answer is adenocarcinoma, which is a Malignant, intestinal type glands in the distal 1/3 of the esophagus. The other options represent different conditions that can be seen in the esophagus but are not the result of longstanding Barrett's esophagus.

Explanation

The correct answer is adenocarcinoma, which is a Malignant, intestinal type glands in the distal 1/3 of the esophagus. The other options represent different conditions that can be seen in the esophagus but are not the result of longstanding Barrett's esophagus.

6. Which compartment gives rise to most stomach cancers, Foveolar or Glandular?

Foveolar

Mucous

Parietal

Glandular

Stomach cancers mostly arise from the glandular compartment due to the presence of glandular tissue that is more prone to developing cancerous cells compared to the foveolar, mucous, and parietal compartments.

Explanation

Stomach cancers mostly arise from the glandular compartment due to the presence of glandular tissue that is more prone to developing cancerous cells compared to the foveolar, mucous, and parietal compartments.

7. What percent of primary gastric malignancies are adenocarcinomas? What percent of cancer deaths? Where is there highest prevalence?

85% 2% United States, Canada

95%2.5%Japan, Iceland

80% 5% China, India

70% 3% South Africa, Brazil

Adenocarcinomas account for 95% of primary gastric malignancies and 2.5% of cancer deaths. The highest prevalence is in Japan and Iceland.

Explanation

Adenocarcinomas account for 95% of primary gastric malignancies and 2.5% of cancer deaths. The highest prevalence is in Japan and Iceland.

8. What type of adenocarcinoma is this?

Prostate

Intestinal

Lung

Breast

Adenocarcinoma is a type of cancer that originates in the glandular tissue. In this case, the correct type is intestinal adenocarcinoma, which typically develops in the intestines. Lung, breast, and prostate adenocarcinomas originate in the respective tissues in the body.

Explanation

Adenocarcinoma is a type of cancer that originates in the glandular tissue. In this case, the correct type is intestinal adenocarcinoma, which typically develops in the intestines. Lung, breast, and prostate adenocarcinomas originate in the respective tissues in the body.

9. What type of adenocarcinoma is characterized by crescent-shaped nuclei at the edge of the cell due to mucin vacuoles pushing on it?

Mucinous

Intestinal

Papillary

Diffuse (aka signet ring) adenocarcinoma is distinguished by the appearance of crescent-shaped nuclei at the edge of the cell caused by mucin vacuoles pushing on it.

Explanation

Diffuse (aka signet ring) adenocarcinoma is distinguished by the appearance of crescent-shaped nuclei at the edge of the cell caused by mucin vacuoles pushing on it.

10. Where are Sister Mary Joseph nodules?Virchow sentinel node?Krukenberg tumor?

Axilla

Periumbilical areaSupraclavicular areaOvaries

Kidneys

Inguinal area

Sister Mary Joseph nodules are found in the periumbilical area, Virchow sentinel node is located in the supraclavicular area, and Krukenberg tumors typically originate in the ovaries. The incorrect answers provided are not associated with the mentioned conditions.

Explanation

Sister Mary Joseph nodules are found in the periumbilical area, Virchow sentinel node is located in the supraclavicular area, and Krukenberg tumors typically originate in the ovaries. The incorrect answers provided are not associated with the mentioned conditions.

11. What pathology is demonstrated in image?

Diverticulitis

Esophageal varices

Linitis plastica from adenocarcinoma

Gastric ulcer

Linitis plastica is a descriptive term for a type of gastric carcinoma characterized by thickening and rigidity of the stomach wall. Adenocarcinoma is the most common type of cancer that causes this presentation. Gastric ulcer, esophageal varices, and diverticulitis are unrelated pathologies.

Explanation

Linitis plastica is a descriptive term for a type of gastric carcinoma characterized by thickening and rigidity of the stomach wall. Adenocarcinoma is the most common type of cancer that causes this presentation. Gastric ulcer, esophageal varices, and diverticulitis are unrelated pathologies.

12. What CD number is associated with GIST?

CD-117 (c-kit)Proliferation of interstitial cells of Cajal (pacemaker of gut)

CD-8

CD-34

CD-45

CD-117 (c-kit) is the specific CD (cluster of differentiation) number associated with GIST, as it is involved in the proliferation of interstitial cells of Cajal (the pacemaker of the gut).

Explanation

CD-117 (c-kit) is the specific CD (cluster of differentiation) number associated with GIST, as it is involved in the proliferation of interstitial cells of Cajal (the pacemaker of the gut).

13. What are the most common sites for gastric carcinoids?

Colon (5-7)

Pancreas (2-3]

Stomach (2-4)

SI (39%)Appendix (26)Rectum (15)Bronchial system of lungs (10)Colon (5-7)Stomach (2-4)Pancreas (2-3)Liver (<1)

Gastric carcinoids are most commonly found in the small intestine (39%), appendix (26%), rectum (15%), and bronchial system of lungs (10%). Other less common sites include colon (5-7%), stomach (2-4%), and pancreas (2-3%). Liver is the least common site (

Explanation

Gastric carcinoids are most commonly found in the small intestine (39%), appendix (26%), rectum (15%), and bronchial system of lungs (10%). Other less common sites include colon (5-7%), stomach (2-4%), and pancreas (2-3%). Liver is the least common site (

14. What does the acronym GIST stand for in medical terminology?

GISTGastrointestinal stromal tumor (gross appearance seen here)

Gallbladder intracellular sarcoma

Gastric inflammatory syndrome target

Gastrointestinal systemic tumor

GIST stands for Gastrointestinal stromal tumor, which is a type of tumor that typically occurs in the gastrointestinal tract.

Explanation

GIST stands for Gastrointestinal stromal tumor, which is a type of tumor that typically occurs in the gastrointestinal tract.